Traveler's diarrhea

Diarrhea presented by people from developed countries when traveling to developing countries. 

It is caused in up to 90% of cases by a bacterial infection (enterotoxigenic Escherichia coli, Salmonella spp, Campylobacter jejuni and Shigella spp), although it may be of viral or parasitic origin. 

According to the symptoms manifested, it is classified as follows:

• Mild traveler's diarrhea: one or two episodes in 24 hours of unformed stool, without other accompanying symptoms.
• Moderate traveler's diarrhea: one or two episodes in 24 hours of unformed stool, plus one of the following symptoms: nausea, vomiting, abdominal pain, fever and blood in the stool. Includes cases with more than two episodes of loose stools per day without other accompanying symptoms. 
• Classic traveler's diarrhea: three or more episodes in 24 hours of unformed stool with at least one of the following symptoms: nausea, vomiting, abdominal pain, fever and blood in the stool.

They are usually accompanied by general malaise, loss of appetite and increased bowel movements. 

It is diagnosed by clinical questioning which reveals its appearance during travel or within 10 days of return. A stool culture is recommended when accompanied by fever or blood in stool, to rule out infection by more virulent microorganisms. 

Treatment is aimed at ensuring proper hydration (preferably by mouth) and soothing symptoms with usual analgesics and antiemetics.